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Suggest Treatment For Mild Anemia And Missed Menstrual Cycles

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Posted on Mon, 17 Aug 2015
Question: On May 31 I had an asthma attack ( I was housesitting and didn't realize DOWN pillows were a trigger for me) that put me in the ER...after I followed up with my regular doctor after the ER visit (by about 3 weeks) my Dr told me the ER report indicated I was borderline anemic...I've been anemic a couple of occasions in the past, figured it was due to menstruation, but I am going through menopause now and haven't had a period since November 2014. My blood work 5/31/15 indicated my hemoglobin was at 11.65...the precvious blood work I had months before put me a bit over 12....should I have my colon checked? I do also have fibroids which are on the pelvic floor of my uterus and don't trouble me anymore, but they did get big when I had my baby and blocked my cervix opening (they are inside my uterus on the pelvic floor)- could these fibroids be bleeding into a blocked uterus? The PA I saw last (my Dr was out) called me about the anemia and just told me to take a multi-vitamin with iron...I specifically answered if it was a sign of cancer or anything serious, but she said NO, and that some people just tend to be borderline anemic. THen I looked online and sure enough, in non-menustruating women of middle age, it does indicate possible colon cancer and internal bleeding.

In May I asked a question on here about sporadic swallowing difficulties- causing a glottis like difficulty in swallowing- esp bread- going down like a big lump and causing occasional momentary bouts of hiccups and even spitting back up. I haven't been really having much problem with that for a while now...I kept a health journal for a bit to track my swallowing difficulty, but after weeks of nothing to report on that front I lapsed...I still might occasionally have a difficulty with a first bite here and there, but nothing with any regularity. Now that my iron levels and anemia or borderline anemia is an issue, I'm looking at other sources for bleeding that I may not be aware of and the esophagus came up in my online searches....I had an asthma attack on May 31st and did have a chest xray that came back clear and the xrays were looked at by both the ER and my hospital admitting doctor, I even asked her to look at them again to check out my esophagus and throat because I'd had swallowing problems in the recent past. She said everything looked fine. Should I press for an endoscopy? Would the xray show there was no problem or is the swallowing difficulty (even though it's only very occasional now) and the hemoglobin level enough for me to press my doctors to do such a test?
doctor
Answered by Dr. Ramadevi Wani (7 hours later)
Brief Answer:
No need for endoscopy/colonoscopy

Detailed Answer:
Hi,
Welcome to Healthcare Magic.
I am Dr Ramadevi Wani. I will be answering your concerns today. Since you have no periods since November 2014, the mild anemia that you are having is not due to your periods. For sure the fibroids are not causing any bleeding. If there was any bleeding into uterus it would have come out.

What is the color of your stools? If you you any bleeding in intestine it will be blackish. There is no need for endoscopy/colonoscopy as of now since you have only mild anemia. Just get your stools checked for occult blood. Do a urine microscopy test too.

I suggest you take 60mg elemental iron thrice daily along with folic acid and multivitamin tablets atleast for two months and repeat your hemoglobin test after that. In all probability by then your hemoglobin level would have improved.

I hope this helps.
If you have further complaints, I will be happy to answer.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ramadevi Wani (25 minutes later)
Thank you for your time and your expertise, Dr. Wani

My doctor just told me to take 18 mg once a day with a vitamin supplement. I researched and with menopausal women an ongoing concern is that they may get or have too much iron ( I forgot the name for that condition)..I certainly don't want to risk that.

As for my stool, it showed no signs of blood whatsoever, which is why I figured if there was any, it would only be discovered by an occult test. Just today- on my third day of taking iron, my stool did appear darker, but not black, and I know iron will have that effect so I wasn't worried.

I really don't like taking these big pills, so I was wondering if it might be more advisable for me to just carefully make sure I get it in my diet. Honestly, I hardly ever eat red meat, I'm not much of meat eater at all, and I'm afraid the iron containing foods I most eat (cashews, beans, pasta, whole grain bread) seem to be in the 2% - 4% daily value range for that mineral when I look at the labels of the brands I buy. I think I really haven't been getting enough iron in my diet to begin with. I eat healthy for the most part, but I think iron fell through the cracks because I don't pay attention to it. What do you think? Wouldn't getting it from food sources be better? Esp since I'm at 11.65...it doesn't seem like I have much further to go to get back to normal if I try.
doctor
Answered by Dr. Ramadevi Wani (1 hour later)
Brief Answer:
Take at least take 60mg of elemental iron once daily for 2 months.

Detailed Answer:
Hi,
Welcome back.

What I mentioned is therapeutic dose of iron.
Have you checked your serum iron levels? If it is low take therapeutic dose of iron.
Since you had anemia before also I advised therapeutic dose for two months.

If you don't wish to take the therapeutic dose, at least take 60mg of elemental iron once daily for 2 months. This is important. In addition take iron rich food like red meat, poultry, beans, green leafy vegetables, raisins, dates etc. After two months when your iron level becomes normal, you can stop the tablets and continue with iron rich foods only.

I hope this helps. If you have further queries, I will be happy to answer.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ramadevi Wani (15 hours later)
I'm talking to other doctors on here and my own and even 60 mg seems excessive for my numbers. I will get a hematocrit test soon and will re-check my hemoglobin levels then, but for now I'm going to go with just the iron rich dietary changes and the multivitamin with 18mg....60 seems excessive and heart disease runs in my family, I also don't want to hurt my darling liver which is such a trooper for me by loading it up during menopause with too much iron. Your recommendation scares me for now.
doctor
Answered by Dr. Ramadevi Wani (8 hours later)
Brief Answer:
While repeating your hemotocrit please get your iron profile done.

Detailed Answer:
Hi,
Welcome back.

Since you have previous history of anemia and mild anemia now, it means that you do not have good iron reserve in the body. So I asked you to take 60 mg of elemental Iron daily. Only a maximum of 10% of it gets absorbed from intestine.

This helps to replenish the iron reserves. Taking this treatment just for 2 months is definitely not going to harm you in any way.

While repeating your hemotocrit please get your iron profile done. This will guide regarding the treatment you need to take.

With best wishes,
Dr Rama
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Ramadevi Wani

OBGYN

Practicing since :1985

Answered : 1459 Questions

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Suggest Treatment For Mild Anemia And Missed Menstrual Cycles

Brief Answer: No need for endoscopy/colonoscopy Detailed Answer: Hi, Welcome to Healthcare Magic. I am Dr Ramadevi Wani. I will be answering your concerns today. Since you have no periods since November 2014, the mild anemia that you are having is not due to your periods. For sure the fibroids are not causing any bleeding. If there was any bleeding into uterus it would have come out. What is the color of your stools? If you you any bleeding in intestine it will be blackish. There is no need for endoscopy/colonoscopy as of now since you have only mild anemia. Just get your stools checked for occult blood. Do a urine microscopy test too. I suggest you take 60mg elemental iron thrice daily along with folic acid and multivitamin tablets atleast for two months and repeat your hemoglobin test after that. In all probability by then your hemoglobin level would have improved. I hope this helps. If you have further complaints, I will be happy to answer.